Apicoectomy Surgery Houston

When a tooth becomes sensitive or has deep decay, sometimes a root canal is necessary to remove the diseased tissue (blood vessels, connective tissue, and nerves) from the inside of the tooth. This tissue lies in a canal in the center of the root. During a root canal, an access hole is made in the top of the tooth and small instruments are used to remove this tissue and reshape the often flat or ribbon-shaped canal into a more rounded profile.

Once this is accomplished, the canal is sealed with a filling material to keep any residual diseased tissue from leaking out into the surrounding bone and causing irritation or infection. The goal of the root canal is twofold: one, to remove the tissue in the canal, and two, to seal the canal, especially in the portion near the tip of the root.

People tend to think of the root canals as discreet, round, simplistic systems. However, the canal system is usually somewhat flattened in profile and may contain branches or extra canals which are not visible or accessible with traditional techniques. Because of this, it may be impossible for anyone to successfully treat that particular tooth with the traditional root canal techniques. This is a problem that will not resolve itself or go away without some intervention. Oral antibiotics are never a satisfactory, long-term solution either because the source of infection has not been removed.

A second option would be to retreat the tooth with the traditional technique. While this is not at all unreasonable, there are often some mitigating circumstances. In most cases, the tooth has been restored with a crown. Retreatment necessitates damaging that restoration by creating a large hole into the top of the tooth. An additional issue is more of a philosophical one. Most root canals fail not because of poor treatment but because of anatomic peculiarities that make treatment with the traditional techniques difficult or impossible. Those peculiarities are still present, and because of this, retreatment often has a relatively low success rate.

The third option is apical surgery (apicoectomy). This involves accessing the tip of the root directly and removing the diseased tissue, then preparing and filling the root tip itself. By making an incision in the gum tissue overlying the tooth, your surgeon then accesses the tip of the root. The root tip is then removed, and a small filling is made in the root tip and filled with a sealer to prevent further leakage of material out of the tooth. After a brief healing period, the gum tissue returns to normal.

The surgery itself is performed in an oral surgery office operating suite with either local anesthesia, IV sedation, or general anesthesia. While many patients prefer to have only a local anesthetic (the administration of numbing medicine to the area being worked on) more often, patients choose to be asleep or sedated. That is a decision best left up to the doctor and patient and can be explored more fully during your consultation visit.